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General NPI Number Information
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NPI Number | 1952923708
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Entity Type | Organization
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Legal Business Name | FOOT DOC PLLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 955 N MCQUEEN RD STE 1
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City | CHANDLER
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State | AZ
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Zip | 85225-8129
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Country | US
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Telephone | 480-744-6234
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Fax | 480-907-0500
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Provider Business Mailing Address
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Address Line | 955 N MCQUEEN RD STE 1
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City | CHANDLER
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State | AZ
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Zip | 85225-8129
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Country | US
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Telephone | 480-744-6234
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Fax | 480-907-0500
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN O'BRYANT
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Credential |
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Telephone | 480-744-6234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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